GELOXD/P-GEMOXD 方案治疗初治鼻型结外 NK/T 细胞淋巴瘤的疗效和耐受性：一项多中心回顾性研究。
Efficacy and tolerance of GELOXD/P-GEMOXD in newly diagnosed nasal-type extranodal NK/T-cell lymphoma: A multicenter retrospective study.
机构信息
Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.
The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
出版信息
Eur J Haematol. 2018 Mar;100(3):247-256. doi: 10.1111/ejh.13004. Epub 2018 Jan 11.
OBJECTIVES
Nasal-type extranodal natural killer NK/T-cell lymphoma (ENKTCL) is a distinct type of non-Hodgkin lymphoma with poor prognosis. This research aimed to evaluate the efficacy and safety of the GELOXD or P-GEMOXD regimens in patients with ENKTCL.
METHODS
Newly diagnosed ENKTCL patients treated with either the GELOXD or the P-GEMOXD regimen were identified from three cancer centers between January 2010 and December 2016. Kaplan-Meier and Cox regression analyses were used to calculate overall survival (OS) and progression-free survival (PFS) and to investigate prognostic factors.
RESULTS
One hundred and eighty-four cases were identified from three cancer centers. After 1-5 treatment cycles of GELOXD or P-GEMOXD chemotherapy, 155 (84%) patients showed a complete response (CR). The 3-year OS (73.0% vs 38.2%, P = .001) and PFS (72.8% vs 32.4%, P = .000) rates were significantly higher in early-stage patients compared with advanced-stage patients. A multivariate analysis revealed that patient CR status was a significant independent factor in disease prognosis. Grade 3/4 leukopenia occurred in 43 (23.4%) patients. Major non-hematological toxicities included nausea (n = 117, 63.6%) and vomiting (n = 66, 35.9%).
CONCLUSIONS
The GELOXD and P-GEMOXD chemotherapy regimens are well tolerated and provide favorable survival outcomes in patients with ENKTCL.
目的
鼻型结外自然杀伤细胞/T 细胞淋巴瘤（ENKTCL）是一种预后不良的独特非霍奇金淋巴瘤。本研究旨在评估 GELOXD 或 P-GEMOXD 方案治疗 ENKTCL 患者的疗效和安全性。
方法
从 2010 年 1 月至 2016 年 12 月，在三个癌症中心确定了接受 GELOXD 或 P-GEMOXD 方案治疗的新诊断的 ENKTCL 患者。采用 Kaplan-Meier 和 Cox 回归分析计算总生存期（OS）和无进展生存期（PFS），并探讨预后因素。
结果
从三个癌症中心共确定了 184 例患者。在接受 1-5 个周期的 GELOXD 或 P-GEMOXD 化疗后，155（84%）例患者达到完全缓解（CR）。早期患者的 3 年 OS（73.0%比 38.2%，P=0.001）和 PFS（72.8%比 32.4%，P=0.000）率明显高于晚期患者。多变量分析显示，患者的 CR 状态是疾病预后的显著独立因素。43（23.4%）例患者出现 3/4 级白细胞减少症。主要的非血液学毒性包括恶心（n=117，63.6%）和呕吐（n=66，35.9%）。
结论
GELOXD 和 P-GEMOXD 化疗方案在 ENKTCL 患者中耐受良好，提供了良好的生存结果。
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